Wednesday, October 1, 2008
Monday, September 29, 2008
Patient: Yeah, I'm allergic to hydrocodone.
Are you currently taking any medicines?
I take Lortab for my knees?
You are allergic to hydrocodone, but take Lortab? You know hydrocodone is the generic name for Lortab?
Yeah, but when is says Lortab, I'm not allergic.
Monday, September 22, 2008
Tuesday, September 2, 2008
I work in occupational health. I am the only nurse for 500+ employees. I wear the hats of mother, therapist, friend, confidant, sounding board, and nurse. I see them everyday--in the hallways, in the cafeteria, in the parking lot. I get invited to their birthday parties, weddings and baby showers. I see them and care about them as PEOPLE, often friends, not just patients. And I LOVE that about my job....
Which is the reason the past couple of weeks have been difficult.
An employee came to me with left sided facial numbness that she noticed when she was getting ready for work. After examining her, I concluded that she most likely had Bell's Palsy. I called her doctor and explained my findings. The doctor concurred and called in a couple of prescriptions for her with instructions for her to make an appointment in a week. The employee went to her follow-up appointment. Just to be safe the doctor did a CT--she has Bell's Palsy AND a brain tumor (the tumor isn't causing the facial numbness because it is in a different area of the brain.)
Another employee has been struggling with a recent CABG and newly diagnosed cancer. Now he has had a massive stroke.
Some days I wish they were just patients....
Monday, August 18, 2008
Monday, August 4, 2008
Saturday, June 28, 2008
Friday, June 13, 2008
I would beg to see your arms raised in calcification towards the expanding horizon as the minutemen stand before me with their phallic gums aimed and loaded..I don't even want to know what "phallic gums" are especially if they are "aimed and loaded." But the fact that they are "minutemen" leaves me less than impressed.
h/t Matt G
Sunday, May 25, 2008
Wednesday, May 7, 2008
Saturday, April 12, 2008
While trapped in Wal-Mart by a sudden and violent thunderstorm a little over a week ago, I found myself browsing the book section waiting for a break in the storm. A book seemed to call me: Marley and Me. I picked it up and debated for a few seconds then threw it in my basket. The day before was the 2nd anniversary of the death of my dog Sherman.
One day in September of 1998 a received a cryptic phone call from a friend telling me to come over to her house. When I arrived at her house, there he was. A fat, black and tan dachshund puppy. Only 5 months before this same friend had given me tiny red dachshund puppy for my birthday. I thought to myself what in the world am I going to do with another puppy? I took him into my arms, smelled his puppy breath and knew what I was going do--take him home.
Naming a dog Sherman when you live in the heart of Dixie may seem strange. He was named not for the yankee bastard who burned his way through the South, but for the tank. And a tank he was.
His was a sad beginning for a puppy. A product of a puppy mill, he had spent his entire life, until the day my friend bought him at a bargain price from a pet shop, in a small wire cage. He was nearly 4 months old and was no longer "puppyish" enough to sell for full price. He was fat and had very little muscle. The pet shop owner was happy to see him go.
So, Sherman and I went back to my little 2 bedroom rental house. I lifted him from my truck and put him down in the driveway. He followed me to the doorstep and stopped. He had no idea how to get up on the 3 inch high slab of concrete. I called to him and cajoled, but he didn't budge. He simply looked at me as if I'd asked him to climb Everest. When you have spent your whole life in a cage, everything is new and challenging.
I picked him up and brought him into the house to meet my other puppy, Sam. Apparently playing and running were also new to Sherman. He quickly caught on and from that time forward he ran every where he went. I held him in my lap that first night after he wore himself out running and playing, feeling his heart beating so fast and so hard I was afraid it would burst.
I didn't know if Sherman and I would make it through that first year. He was hardheaded and resisted being housebroken. He also had a terrible habit of shredding everything. I came home from work one day to find the entire house covered in foam from a chair and shredded magazines. Sherman was proudly standing in the middle of it all.
After that first year, I bought a house with a huge fenced yard. Sherman had FINALLY figured out that he needed to go outside to go potty. By this time it was apparent he was not a miniature dachshund as advertised. Once he learned to run and jump, the puppy fat melted off and was replaced by 27 pounds hard solid muscle.
Seemingly simple tasks were still challenging for him. I had a doggie door installed so that he and Sam could come and go as they pleased. Sam figured out the doggie door in a few seconds. Not Sherman. Finally, after 2 weeks of pleading and bribing, I'd had enough. I left him outside when I left for work. When I came home that afternoon I went into the house through the other door, leaving him outside. For a while he stood outside the door and whimpered and cried and barked. Finally I heard the tale tell click, click of the doggy door and the stampede of feet racing towards me. He'd done it! After that, there was no stopping him.
The three of us lived a quiet life in our little home. In 2002 another dog, Otis, came to live with us. We all plodded along until I met someone in 2004 who would change all our lives and introduce Sherman to one of his great joys in life.
U-J and I began dating in August of 2004. I had just started nursing school. We spent every weekend together. Our usual weekend routine consisted of U-J getting up earlier than me. He'd fix himself a cup of coffee (something I never drink) and play on the internet until I got up. He began to notice that his coffee seemed to disappear every time he left it on the table. One morning he returned to find Sherman nose-deep in his coffee cup, tail wagging wildly. Sherman was hooked! No cup of coffee was ever safe after that.
2004 also brought another member to our little four-legged family. I had just arrived home after spending Thanksgiving with U-J's family. I'd left the dogs at home and had a friend look in on them once or twice while I was gone. Curled up in a nest of leaves outside the fence was a tiny ball of black fur. Somehow this tiny puppy had found her way to my house. Sherman instantly became a mother hen to her. He'd sleep by her kennel to keep her from being lonely, go to her when she'd cry, and bark at her when she was bad. I knew I couldn't keep her. I was in nursing school and didn't have time to care for a 5 week old puppy. U-J and I debated what to do. He finally ended up taking her home to live with him. So, Josie became our 4th dog.
The next year and a half passed with me going to nursing school and dating U-J. Then one day in March of 2006 I heard an awful yelping noise coming from the back yard. Sherman's body was frozen and he was was crying out in pain. Oh, no not again. Several years earlier Sam ruptured a disc in his back, and I knew the signs. After several minutes, Sherman's body unfroze, but he was obviously in pain. The vet prescribed a steroid shot and confinement to a kennel to see if he would get better. He didn't. The vet referred us to a specialty clinic. X-rays confirmed my fears. Sherman had several herniated discs in his neck and surgery was his only option. Surgery that would cost in the neighborhood of $5000. That was a lot of money to an unemployed nursing student. U-J and I decided we didn't have a choice and told the vet to do the surgery.
The surgery went well. After a few days, I picked him up from the vet. Since I had been through surgery with Sam, I knew what to expect. Since I was in my last weeks of nursing school and stressed out, we decided Sherman should stay with U-J. He didn't better. We'd call the vet and get more drugs. And he only got worse.
Saturday, April 1, 2006 U-J proposed. The next day he was supposed to leave for a week in Florida. Sherman was getting worse. We decided U-J would wait one more day to leave so he could take Sherman back to the vet on Monday. I was starting mandatory NCLEX review classes that Monday and couldn't miss.
The night of April 2nd I stayed up with Sherman all night. He was bloated and his breathing was labored. He was in pain and wouldn't quit crying. That morning I got dressed and headed off to school while U-J took Sherman and headed to the vet.
What should have been a fun day of telling my friends that I was engaged was overshadowed by worry for my once happy energetic dog. U-J dropped Sherman off at the vet and began his drive to Florida. About 3:00 that afternoon he called. He was sobbing and said, "Sherman didn't make it."
I fell apart. I wanted to go home to Sam and Otis but I was dreading being home knowing that I would never again see Sherman running to the fence to greet me when I came home.
I decided to have him cremated. U-J made me promise I'd wait until he returned from his trip to pick up the ashes.
The day finally came to pick Sherman's remains. The receptionist handed me the box. I took the box, thanked her while choking back sobs, and walked outside, tears streaming down my face. He was really gone.
I was now living with U-J full time while doing my nursing externship, but I took Sherman's ashes back to my house. I really didn't know what to do with them, but I knew this was his house and where he had been the happiest.
U-J and I married later that year and bought a new house. Sherman's ashes stayed at my house for the next year. One weekend while we were at my house, U-J and I were laying in bed, and I was crying about Sherman. U-J held me tight and said he thought it was time to bring Sherman to our new house because he'd want to be with the rest of his pack. I knew he was right.
I still miss his joy, but I will never forget it.
Tuesday, March 25, 2008
Almost dying saved his life.
Sunday, March 23, 2008
I don't think I've ever talked about my gun on my blog. Well, meet the Pink Commander of Doom (PCoD.) Sadly, the PCoD is only pink at heart. But now, thanks to the talent of the XMan, I have a custom-made hot pink holster AND dual magazine pouch! How awesome is that!
Friday, March 14, 2008
Me: Of course, and she's going to name him Lady.
Thursday, March 13, 2008
Monday, March 10, 2008
Worker's Comp Dos and Don'ts:
DO believe the nurse and HR wants to help you if you are legitimately injured on the job.
DON'T think you have to fake an injury to get the help you need.
DO report an injury when it happens.
DON'T file an accident report saying you have been hurting for 4 months, request to see the worker's comp doctor and tell him, "Oh, I don't know for sure that I hurt myself at work. Work just makes me tired, and I want some muscle relaxers."
DO be honest about your injury.
DON'T change your story, and when you are confronted with your previous statement say, "Well, that's not what I meant."
DO see the on-site nurse as soon as possible after you are injured.
DON'T go see your chiropractor and get an "adjustment" and then file for worker's comp when he ruptures your disc.
DO keep all your doctor's appointments.
DON'T tell the nurse you didn't go because "something came up" TWICE!
DO follow the nurse's treatment plan.
DON'T say you need more NSAIDs for your tennis elbow because you spread gravel on your driveway this weekend.
DO realize you have some responsibility in taking care of your body and preventing work place accidents.
DON'T be surprised when the nurse tells you that your knees hurt in part because you are 5 feet tall and weigh 280 pounds.
DO realize as you age shit begins to hurt.
DON'T think you are entitled to a life with no pain (no matter what Joint Commission says.)
I think that just about covers it for now.
Monday, March 3, 2008
Sunday, March 2, 2008
Monday, February 25, 2008
real places, names, things...nothing made up!
WHAT IS YOUR NAME? Dixie
4 LETTER WORD: Door
TV SHOW: Dynasty
BOY NAME: David
SOMETHING YOU WEAR: diamonds!
CELEBRITY: Donald Sutherland
FOOD: dungeoness crab
SOMETHING FOUND IN A BATHROOM: dirt
REASON FOR BEING LATE: dog escaped the fence
CARTOON CHARACTER: Droopy
SOMETHING YOU SHOUT: Damn!
Please feel free to play along.
Sunday, February 24, 2008
Only 8 months ago pdb and I were having this IM conversation:
"So, how's Mrs. pdb? Is she still tired and nauseous?"
"No, she took a test."
"I'm telling you, she's pregnant."
Then 7 months ago we had this IM conversation:
"So, how's Mrs. pdb? Is she still tired and nauseous?"
"No, she went to the doctor."
"I'm telling you, she's pregnant."
6 months ago I get a call from U-J while I'm driving home from work, "Call pdb."
"Hey, what's up, U-J told me to call you?"
"I TOLD YOU SO!"
Congratulations Mr. and Mrs. pdb. I've never been so happy to be right.
Friday, February 22, 2008
Tuesday, February 12, 2008
Monday, January 28, 2008
I had a patient once who's resuscitation status read:
If patient is in respiratory arrest, DNR. If patient is in cardiac arrest, chemical code only, no CPR, no intubation.
I do not understand why doctors won't explain exactly what DNR means. It is an all or nothing proposition.
Don't intubate-if the patient survives they will be severely brain damaged.
Chemical code only with no compressions-the drugs don't go to the heart where they can work.
Sorry, you are either a DNR or not. This is not the kind of treatment you can customize.
Tuesday, January 22, 2008
In addition to the maggots, Anthony Digiannurio, of Deltona, Fla., was found with an infected breathing tube, a partially inserted catheter and bed sores when he was taken to Florida Hospital DeLand from the University Center West nursing home in November, according to the report.
It was not immediately clear if the death was associated to his care.A representative from the nursing home said Digiannurio had "constant care from multiple hospice workers and two certified nursing aides at the nursing home."
A) Every staff person who signed that chart or had direct contact with that patient should be in jail
B) "It was not immediately clear if the death was associated to his care." Well, it certainly didn't help.
Monday, January 21, 2008
Bet you can't guess what happened......
How could anyone bring a convicted child molester into their house and put their child at risk?
Wednesday, January 16, 2008
So the head of our department got called to the Big Boss's office to explain.
She divided the people who left into categories. Most of the people who left were in the "Moved Away Because Spouse Got New Job" category.
To which she was told, "People don't leave jobs they love, they get divorces."
So, I thought this statement called for a poll:
Monday, January 14, 2008
Friday, January 4, 2008
Who can help her now, you ask?
Chuck Norris, of course!